Pelvic Floor Dysfunction

The muscles and connective tissues that make up the floor of your pelvis form a hammock that spans from your tailbone to your pubic bone, creating a wall of separation between your perineal region and your pelvic bowl. The pelvic floor provides support for your intestines, bladder and uterus, and its muscles govern bladder, bowel and sexual function. The muscles also facilitate childbirth as the fetus descends, causing the baby to rotate as it enters the birth canal.

Dysfunction of the Pelvic Floor

Signs that your pelvic floor may not be doing its job often begin with bladder and bowel leakage or constipation. High-impact sports like gymnastics, basketball and running create downward pressure on the pelvic floor muscles, putting athletes in those sports at risk for dysfunction. Pregnancy and childbirth may also lead to pelvic pain and dysfunction.

Prevalent symptoms include:

Urine leakage during exercise

Leakage when coughing, sneezing or laughing

Difficulty emptying your bladder and/or bowels

Sudden loss of bowel control

Gassiness

Prolapsed uterus or organs

Pain in the pelvis

Urine leakage during intercourse

Chronic Pelvic Pain (CPP)

Pain that persists for six months or longer is categorized as chronic, and CPP can seriously interfere with normal daily activities. CPP is common in women, accounting for about 10% of all visits to the gynecologist. It is also a relatively common urologic complaint among men under age 50.

Causes of Pelvic Floor Dysfunction

A number of anatomical changes can lead to pelvic floor dysfunction. Tight or weakened muscles, joint impairment in the low back or pelvis or sensitive painful tissues may be contributing factors.

Other causes include:

Infections

Postural issues affecting the pelvis and low back

Trauma

High-impact physical activities

Surgery

Obesity

Sedentary lifestyle

Pregnancy and childbirth

Subcategories of pelvic floor dysfunction include:

Bladder disorders

Bowel disorders

Sexual dysfunction

Post surgical issues

Diagnosis of Pelvic Floor Dysfunction

Diagnosis begins with a medical history and physical exam of the pelvic floor. Your clinician will ask for detailed information about pregnancies and childbirth, and any difficulties or abnormalities you experienced associated with childbearing. They will also ask for details about surgical procedures in the pelvic region. Bowel patterns, nutrition, physical activity and lifestyle habits may hold clues that can help your provider make an accurate diagnosis.

At NYDNRehab, we use dynamic real-time ultrasound to visualize the structures of the pelvic floor. During a diagnostic ultrasound session, both patient and clinician can view the muscles of the pelvis in motion to assess for abnormalities.

With real-time ultrasound imaging, we are able to diagnose and treat a number of conditions, including: